The ability to communicate vocally is a skill many people take for granted. However, some people lose their ability to talk due to a surgical procedure like a laryngectomy. A laryngectomy is an operation in which the larynx (or “voice box”) is removed from a patient due to laryngeal, oesophageal or pharyngeal cancer [1]. A number of alternatives are available to the patient to give them a means to communicate, however, as indicated below, none of these devices produce natural sounding speech.
Anatomically, the larynx is part of the conducting tube that joins the pharynx and the trachea. It has two main functions [2]:                1. to prevent food or drink from entering the trachea and lungs during swallowing; and        2. to produce sound.        
It is made up of a number of different cartilages and muscles which hold the larynx open during breathing and which close the laryngeal opening (glottis) during swallowing and in speech. The epiglottis is a spoon-shaped structure that aids in closing the glottis during swallowing. The vocal folds in the larynx are controlled by muscles and are used in sound production [2].
A laryngectomy is a procedure used to remove the larynx. In a laryngectomy, the entire larynx including the thyroid and cricoids cartilages is removed [3]. Once this has been done the upper part of the trachea is attached to the front of the neck to create a permanent opening (the tracheostoma) [4]. This is illustrated in FIG. 1. The tracheostoma is mainly for breathing purposes. The laryngectomy results in the patient being totally unable to phonate and this is due to the complete removal of the vocal cords.